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Gastric Cancer

Treating Stomach Cancer

Summary & Participants

Gastric cancer, more commonly known as stomach cancer, is one of the most common cancers in the world. Learn more about this cancer and what treatments are available.

Medically Reviewed On: July 16, 2008

Webcast Transcript

ANNOUNCER: Treatment for gastric cancer, or cancer of the stomach, depends on how far the cancer has spread in the body. Doctors rate the extent of the disease through a process called staging.

DAVID ILSON, MD: Staging, basically, is defined by the depth of penetration of the tumor into the stomach wall, so that stage I would be very superficial involvement of the stomach lining. Stage II would be tumors that are more deeply penetrating into the muscle lining or through the wall of the stomach. And stage III disease typically is lymph node—involved cancer. Stage IV disease, which is the highest stage, would be distant metastasis, involving the liver or other sites away from the stomach.

ANNOUNCER: Early stages of gastric cancer are treated primarily with surgery.

DAVID ILSON, MD: For early stage disease, stage I disease or early stage II, surgery alone probably is adequate treatment. It's not clear that adding other therapies to early stage disease improves survival compared to surgery alone.

ANNOUNCER: There are two main types of surgery: a subtotal gastrectomy, where a portion of the stomach is taken out; and a total gastrectomy, where the entire organ is removed.

MANISH SHAH, MD: Depending on how extensive the tumor is within the stomach and also where it is within the stomach, we would choose either for a total gastrectomy, if the tumor was involved throughout the stomach, or a subtotal gastrectomy if only part of the stomach was involved.

ANNOUNCER: Regional lymph nodes are also removed and tested.

MANISH SHAH, MD: There are six chains of lymph nodes on the inside curve of the stomach or on the outside curve of the stomach. And removing all those lymph nodes is important to accurately stage the tumor, meaning accurately determine how advanced the tumor is.

JOHN MACDONALD, MD: If there's no cancer in the lymph nodes, those patients don't need any further treatment, and they have a high probability of being cured, maybe 80 to 90 percent.

ANNOUNCER: Gastric cancer can be cured if detected early. But few patients experience symptoms in early stages and most aren't diagnosed until the cancer has advanced.

DAVID ILSON, MD: Because we do not have effective screening and because gastric cancer is rare, most patients present with symptomatic disease and with more advanced cancer. So stage III, stage IV disease is much more common.

ANNOUNCER: If the tumor has spread outside of the stomach to the lymph nodes, it is considered stage III cancer. It is treated with surgery, followed by radiation and chemotherapy.

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